“Community-based prevention has a proven track record when it comes to saving lives and improving health and wellbeing,” said Sheila Savannah, director at Prevention Institute. “We increasingly know what to do and need to build on what works. That means investing in the factors that ensure all our communities are healthy, safe, and vibrant places to live—places of connection and opportunity.”

The approaches outlined in the infographic—and discussed at greater length in our recent report, Back to Our Roots: Catalyzing Community Action for Mental Health and Wellbeing—call for the nation to move ‘upstream’ to address the sources of despair that lead to substance misuse, addiction, overdose, and death in communities where hope and a sense of opportunity need to be restored. It emphasizes the value of social support, affordable housing and job opportunities, as well as the need to strengthen “pillars of wellbeing” like belonging/ connectedness, dignity, safety, and trust. Back to Our Roots and the Path Forward infographic were funded by the Blue Shield of California Foundation.

According to Pain in the Nation, over the past decade, one million Americans have died as a result of substance misuse or suicide, and in 2016, life expectancy dropped for the first time in two decades. The report examines how these public health crises play out state-by-state, then issues a call for a national resilience strategy to transform the condition that underlie these health challenges.

The response to this crisis must expand in its reach and imagination. Pain in the Nation describes a number of policies and programs to improve mental wellbeing, including our Making Connections Initiative. Making Connections, funded by the Movember Foundation, focuses on improving the mental health and wellbeing of men and boys in the U.S. and includes sixteen locations that are developing strategies to improve social connections, economic and educational opportunities, and improvements in the physical environment.

The Making Connections sites are among many local efforts that focus on community factors, not just individual factors, because the right community conditions can support people’s ability to cope and thrive, and the wrong conditions can exacerbate and even create anxiety, stress and trauma. Below are a few examples:

In Tacoma, Washington, community organizations are addressing the ways communities are designed to ensure access to healthy food retailers, parks, affordable housing, and quality jobs.

The Southern Plains Tribal Health Board in Oklahoma City seeks to reduce suicide among American Indian men and boys by working within the school system to engage and train youth to recognize and report warning signs of suicide among their peers.

In Salinas, California, the public health department partners with the local library system and other public institutions to give kids safe, welcoming places to go after school. (For other examples related to early childhood interventions, see our Cradle to Community Project, supported by the Robert Wood Johnson Foundation.)

In Canton, Connecticut, veterans of multiple generations provide support to one another and create opportunities for connection through a peer network.

In Chicago, Illinois, Sinai Health System is partnering with African-American and Latino men and boys to increase access to parks and safe places to play and be active.

To get ahead of this epidemic, we need strategies like those outlined above—which focus on sowing resilience and strengthening the fabric of community life—to work hand-in-hand with treatment and recovery services.